crotchitymedic1986

The questions to ask in response would include; how many inadvertent oesophageal intubations occurred before capnography proliferated, or how many RVI's were given nitro and subsequently crashed prior to XII lead proliferation, or how many people having a stroke were delivered to the ER rather hypoglycaemic before the proliferation of POC blood glucose testing? Take care, chbare. Intubations: I think we had a better percentage of that, if you read recent literature about how bad today's medics perform in this area. RVIs, I would say 12 lead has made no difference in this, as most medics can still not accurately read a 12lead. I have never had any problem differentiating between stroke and hypoglycemia with or without a glucometer. But to retort: How often does RSI result in a non-successful intubation these days (and how often do you see medics digging in an airway for 20 minutes onscene, without ventilating properly in between attempts? How many non MI chest pain patients are treated as such by EMS, because we were taught in school that chest pain =s MONA no matter what ? How many CVAs and Hypoglycemic patients are not even transported by EMS these days versus the old days ? We didnt leave folks at home at a 40-50% rate. I grant you that the internet and 24 hour media make it easier to hear of EMS mistakes than it was in the old days, but I just don't remember us killing as many patients as what I read on a weekly basis today.

The first rule should be to do no harm. If the patient is stable we should not be "shock happy". Sure, start your IV, do your 12-lead, put on some pads if it makes you feel better, but anyone who shocks this patient should have their certification pulled. It's a funny thing, you give a medical clinician a tool, and they abuse it. Go to any EMS/Fire Dept that has recently purchased the "drill" and then look at how many patients have been "drilled" since that purchase, versus how many IOs were attempted in the year before. Technology is a good thing, but you have to treat the patient first. What would you do if you were a wilderness EMT out in the boonies with this patient, and had no cardiac monitor or 12Lead ? All us old-timers found a way to treat our patients without glucometers, pulse oximeters, capnography, IOs/Drills, or 12 lead EKG.

Treat the patient not the monitor !!!!!!!!

Cant answer for Texas, because each state sets their own rules; but since most states model their Medicaid program off of Medicare, the answer is probably no. Not sure why you asked but if you are looking to get in the business, you are starting off on the wrong foot. Medicaid barely pays better than self-pay patients, you should limit your Medicaid business to as little as possible. Also, hospital based is reimbursed different from regular ambulance service. I would schedule a meeting with another Texas-based Hospital EMS system and ask them what they do.

It's none of your business, and you are putting yourself at great risk anytime you disuade someone from transport. You do not have the proper equipment to make a diagnosis on the scene. You should let the patient make that decision with the transport crew. If the transport crew decides to talk them out of transport, then the liability is on them. Pretend you are in front of the judge: Lawyer to patient, why did you call 911 ? I was sick and wanted to be transported to the hospital. Why weren't you ? EMT FSU told me that I did not need to go by ambulance. Lawyer to EMT FSU, "What did you base your decision to cancel the ambulance on ? EMT FSU: she had normal vital signs, and WWE was on TV so I didnt want to wait 30 minutes on the ambulance. Lawyer to EMT FSU, Dr. Megabucks at the local ER says this patient needed a complete laboratory workup, an x-ray, and an MRI; did you perform any of these tests in the field ?

Not really looking for replies, but I am rather just putting out the warning. If you spend any time googling phrases like "privatize ems" or "county cuts EMS budget", you will see that this is the definite new trend (not really new, just resurfacing). Like it or not, private companies can provide EMS at a much lower cost than their government counterparts. There are even several Fire Departments who are under the threat of privitization. You need to make sure that your Chiefs can justify your budget, especially if you run a bloated department (double medic, too many chiefs, running expensive equipment that cost double what you could get it for if you had too, or if you are just a first-responder department that does not produce revenue).

We all know that our parents/grandparents generation can tell you exactly where they were and what they were doing when they heard that JFK had been assasinated. There is no doubt that 9/11 was our generation's similar event. I am not raising this topic to bash Muslims, talk about the NY Mosque, or the Florida Bible-Thumper who wants to burn some books. I just wonder, where were you when you learned about 9/11, what were your initial thoughts, what are your thoughts in retrospect (if you care to share) ?

Sorry dudes and dudettes, this IS NOT VTACH. Treat your patient, not the monitor. And you may be amazed to know that there are patients who go in and out of VTACH, SVT, and have arrests that last greater than 6 seconds several times per day, and live without a Paragod's intervention (although they usually get a pacemaker or internal defibrillator shortly after it is found).

Hey INF, how about trying this: After you have actually administered atropine to 10-15 patients, you can come in here and tell us all about it.

Its a problem now because this is probably the first time she has been tested since she took her Paramedic Registry Exam. I know there are departments out there who really do training well, and ensure that their medics are competent, but the reality is that probably 95% of EMS agencies rely on CPR, ACLS, and a quickie weekend 40 hour refresher course two weeks before their certification expires.

What if the City of New York is smarter than we think ? What if they did this as an insurance policy; as long as their is a mosque near ground zero, it will never be bombed by muslims again. As far as those who cry "hypocricy", this is no different than illegal immigration from Mexico. The Mexican Goverment screams every time something happens to slow down illegal immigration in to the US, but they have a very different, more strict policy when it comes to illegal aliens getting IN to their country. When these sorry ass Muslim Terrorists allow us to build a Baptist Church in Mecca, I will allow a mosque (code word for terrorist training camp) at Ground Zero. I say instead of deer season, we have Muslim hunting season: You get $100.00 for every bullet-idden burka you turn in.

If this sounds smart-ass or arrogant, I am not intending it that way; but the answer to your question is the same answer you would give to a woman who asks, "why do all my boyfriends beat me up ?" The answer is that she is attracted to bad boys who beat her, and will continue to date men who beat her (her issue is usually lack of self-esteem). We are all attracted to something that draws us to certain people. You have not dated different people, you have been dating the same woman over and over, ones that treat you like crap. Whatever the reason, you find women who treat you like shit attractive. If you were to walk into a room of 100 women, you probably wouldnt pay attention to more than 1-3. Those are the three you should avoid from now on, as those 3 are the women you have been dating over and over again. Its time to shake things up, next time you walk in that room full of 100 women, pay attention to the other 97.

We are very close in thought. There has always been terrorists, and there will always be terrorists, it is just Muslims are the flavor of the decade(s) for now. There are all types of religous fanatics (in ALL religions), and all kinds of generalized nuts, but right now the Muslims are doing more damage.

It rained in my backyard today, therefore it must have rained in yours ? I do not have any stray dogs in my yard right now, so there must not be any strays anymore ? I am glad that you can cite some statistics from two small areas of the country, but I promise you that the national prison statistics on race are anything but equal. I imagine that the cops in Alaska dont pull over too many black folks either (probably because both the black people in Alaska are already in jail). But back to the original question that I asked, why is driving legally in an area that your race is not the majority, a reason to pull you over ?

I am sorry, the vast majority of deadly attacks have been at the hands of muslims. And funny thing is, you never see any "good muslims" denouncing their evil counterparts.

Why did you deserve to be pulled over, just because you were driving in area that your race is not popular in ? Yes, you might have been up to trouble, but if they did not see you committing a crime, there is no legitimate reason to pull you over. But I am glad you got a taste of our life.

What it says, and what it is in reality is two different things. Its like your Policy and Procedure book at work; it says one thing, individual medics choose to do the opposite every day.

Really, please correct me; how many terrorists attacks can you name since 2000 that were not conducted by Muslims ? But to make you happy, I will edit my original response: Since Timothy McVeigh, all terrorists have been muslims. Here is a list of recent attacks, tell me how many were not conducted by Muslims: 1995 April 19, Oklahoma City: car bomb exploded outside federal office building, collapsing wall and floors. 168 people were killed, including 19 children and 1 person who died in rescue effort. Over 220 buildings sustained damage. Timothy McVeigh and Terry Nichols later convicted in the antigovernment plot to avenge the Branch Davidian standoff in Waco, Tex., exactly 2 years earlier. (See Miscellaneous Disasters.) Nov. 13, Riyadh, Saudi Arabia: car bomb exploded at U.S. military headquarters, killing 5 U.S. military servicemen. 1996 June 25, Dhahran, Saudi Arabia: truck bomb exploded outside Khobar Towers military complex, killing 19 American servicemen and injuring hundreds of others. 13 Saudis and a Lebanese, all alleged members of Islamic militant group Hezbollah, were indicted on charges relating to the attack in June 2001. 1998 Aug. 7, Nairobi, Kenya, and Dar es Salaam, Tanzania: truck bombs exploded almost simultaneously near 2 U.S. embassies, killing 224 (213 in Kenya and 11 in Tanzania) and injuring about 4,500. 4 men connected with al-Qaeda 2 of whom had received training at al-Qaeda camps inside Afghanistan, were convicted of the killings in May 2001 and later sentenced to life in prison. A federal grand jury had indicted 22 men in connection with the attacks, including Saudi dissident Osama bin Laden, who remained at large. 2000 Oct. 12, Aden, Yemen: U.S. Navy destroyer USS Cole heavily damaged when a small boat loaded with explosives blew up alongside it. 17 sailors killed. Linked to Osama bin Laden, or members of al-Qaeda terrorist network. 2001 Sept. 11, New York City, Arlington, Va., and Shanksville, Pa.: hijackers crashed 2 commercial jets into twin towers of World Trade Center; 2 more hijacked jets were crashed into the Pentagon and a field in rural Pa. Total dead and missing numbered 2,9921: 2,749 in New York City, 184 at the Pentagon, 40 in Pa., and 19 hijackers. Islamic al-Qaeda terrorist group blamed. (See September 11, 2001: Timeline of Terrorism.) 2002 June 14, Karachi, Pakistan: bomb explodes outside American consulate in Karachi, Pakistan, killing 12. Linked to al-Qaeda. 2003 1 May 12, Riyadh, Saudi Arabia: suicide bombers kill 34, including 8 Americans, at housing compounds for Westerners. Al-Qaeda suspected. 2004 May 29–31, Riyadh, Saudi Arabia: terrorists attack the offices of a Saudi oil company in Khobar, Saudi Arabia, take foreign oil workers hostage in a nearby residential compound, leaving 22 people dead including one American. June 11–19, Riyadh, Saudi Arabia: terrorists kidnap and execute Paul Johnson Jr., an American, in Riyadh, Saudi Arabia. 2 other Americans and BBC cameraman killed by gun attacks. Dec. 6, Jeddah, Saudi Arabia: terrorists storm the U.S. consulate, killing 5 consulate employees. 4 terrorists were killed by Saudi security. 2005 Nov. 9, Amman, Jordan: suicide bombers hit 3 American hotels, Radisson, Grand Hyatt, and Days Inn, in Amman, Jordan, killing 57. Al-Qaeda claimed responsibility. 2006 Sept. 13, Damascus, Syria: an attack by four gunman on the American embassy is foiled. 2007 Jan. 12, Athens, Greece: the U.S. embassy is fired on by an anti-tank missile causing damage but no injuries. Dec. 11, Algeria: more than 60 people are killed, including 11 United Nations staff members, when Al Qaeda terrorists detonate two car bombs near Algeria's Constitutional Council and the United Nations offices. 2008 May 26, Iraq: a suicide bomber on a motorcycle kills six U.S. soldiers and wounds 18 others in Tarmiya. June 24, Iraq: a suicide bomber kills at least 20 people, including three U.S. Marines, at a meeting between sheiks and Americans in Karmah, a town west of Baghdad. June 12, Afghanistan: four American servicemen are killed when a roadside bomb explodes near a U.S. military vehicle in Farah Province. July 13, Afghanistan: nine U.S.soldiers and at least 15 NATO troops die when Taliban militants boldly attack an American base in Kunar Province, which borders Pakistan. It's the most deadly against U.S. troops in three years. Aug. 18 and 19, Afghanistan: as many as 15 suicide bombers backed by about 30 militants attack a U.S. military base, Camp Salerno, in Bamiyan. Fighting between U.S. troops and members of the Taliban rages overnight. No U.S. troops are killed. Sept. 16, Yemen: a car bomb and a rocket strike the U.S. embassy in Yemen as staff arrived to work, killing 16 people, including 4 civilians. At least 25 suspected al-Qaeda militants are arrested for the attack. Nov. 26, India: in a series of attacks on several of Mumbai's landmarks and commercial hubs that are popular with Americans and other foreign tourists, including at least two five-star hotels, a hospital, a train station, and a cinema. About 300 people are wounded and nearly 190 people die, including at least 5 Americans. 2009 Feb. 9, Iraq: a suicide bomber kills four American soldiers and their Iraqi translator near a police checkpoint. April 10, Iraq: a suicide attack kills five American soldiers and two Iraqi policemen. Dec. 30, Iraq: a suicide bomber kills eight Americans civilians, seven of them CIA agents, at a base in Afghanistan. It's the deadliest attack on the agency since 9/11. The attacker is reportedly a double agent from Jordan who was acting on behalf of al-Qaeda. Same list, stated a differnt way: http://www.infoplease.com/ipa/A0884893.html

Do beat yourself up a little, then learn from your mistake, and go on to be a paragod. Acutually there are several studies regarding the elderly and head trauma from ground level falls, I will see if I can dig some up. Throw a little arthritis and osteoporosis in the mix, and you have the potential for fractures (not to mention that most nursing homes and senior living centers have concrete floors covered with linoleum or tile (their hips break pretty easy from a ground level fall, why wouldnt any other bone). What you may or may not know is that the human brain shrinks as we age, which leaves pockets between the brain and skull. When an elderly person has a brain bleed, the signs and symptoms may not show for hours (because the blood fills the "spaces" and does not compress the brain right away). Until you have a CT or MRI machine on your truck, transport all elderly patients who have fallen.

Not all muslims are terrorists ! BUT ALL TERRORISTS ARE MUSLIMS !

Its a racist law, luckily this time it is against the other brown people. Anyone who has been pulled over for DWB (driving while black) knows that the police do not need a real reason to harass you. With that being said, I feel Arizona's pain and understand why they have decided to take action due to the Federal Governments inaction. These people are just trying to find a better life, why is that so wrong. And for all of you who say that illegals take american's jobs = the unemployment rate has been high for two years and i still dont see any unemployed americans doing landscaping or harvesting crops for a living.

Lets change the scenario just a bit, and see if anyone has a different attitude. You are on a cruise to some 3rd world country, you dock, and start enjoying the many amenities and activities that are available. You and your child decide to rent some jet skis, and are having the time of your life when another jetskier (drunk) collides with your jet ski and gives your child a serious head injury. The local hospital is a shack, with no advanced capabilities. There are no neurosurgeons, MRI's, or CT scanners. There is a world renowned Neuro Surgeon from the States on your cruise ship (a passenger like you, on vacation), but he refuses to even look at your child, because he is not covered by his malpractice insurance to treat people in foreign countries, and he lacks the tools that he is accustomed to (so he cant do any good). How do you feel then ?